Left vs Left RCT

Heart Pacing Study for Heart Failure

Recruiting
18 years or above
All
Phase N/A
2136 participants needed
1 Location

Brief description of study

The investigators aim to prospectively test the comparative effectiveness of His or Left bundle branch pacing in relation to patient centered outcomes (quality of life, physical activity, heart failure hospitalization, mortality) and comparative safety in relation to device-related complications and re-interventions (e.g., lead dislodgement, infection) relative to standard of care biventricular pacing in patients with heart failure due to left ventricular systolic dysfunction (LVEF≤50%) and with either a wide QRS (≥130 ms) or with/anticipated >40% pacing who are already receiving current standard heart failure pharmacological therapy.

Detailed description of study

In this prospective, randomized, multi-center clinical trial, the investigators aim to prospectively evaluate the comparative effectiveness His or Left bundle branch pacing (His/LBBP) vs. biventricular pacing (BiVP) in patients with heart failure due to left ventricular systolic dysfunction (LVEF≤50%) and with either a wide QRS (≥130 ms) or with/anticipated >40% pacing who are already receiving current standard heart failure pharmacological therapy by assessing all cause death and heart failure hospitalization at the end of the study.

Additional formal secondary objectives include evaluation disease-specific quality and psychological adjustment changes at 1 year after device implant and evaluation of a composite of death of any cause or heart failure hospitalization or more >15% increase in the left ventricular end-systolic volume index at the end of the study.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Heart Failure, Heart Failure With Reduced Ejection Fraction, AV Block, LBBB, RBBB, Intraventricular Conduction Delay, Pacing-Induced Cardiomyopathy
  • Age: 18 years or above
  • Gender: All

Inclusion Criteria:

  • Men and women 18 years of age or older.
  • A LVEF ≤ 50% within 6 months prior to enrollment.
  • Resting QRS duration ≥130 ms as evidenced by a historical 12-lead ECG prior to enrollment OR anticipated right ventricular pacing >40% OR device in place with right ventricular pacing > 40%.
  • Are optimized on HF guideline directed medical therapy according to current HF published guidelines OR patient's physician will make an effort to start all guideline-directed medical therapy and titrate doses up as permitted by the participant clinical status and co-morbidities prior to implantation procedure.

Exclusion Criteria:

  • Women who are pregnant, lactating, or plan to become pregnant during the course of the trial.
  • Participants with angiographic evidence of coronary disease who are candidates for coronary revascularization and are likely to undergo coronary artery bypass graft surgery or percutaneous coronary, intervention in the next three (3) months.
  • Enzyme-positive myocardial infarction within the past three (3) months prior to enrollment.
  • Coronary artery bypass graft surgery or percutaneous coronary intervention (balloon and/or stent angioplasty) within the past three (3) months prior to enrollment.
  • Reversible non-ischemic cardiomyopathy (e.g., acute viral myocarditis).
  • Participants with Chagas disease, cardiac sarcoidosis or amyloidosis.
  • Expected to receive left ventricular assist device or heart transplantation within 6 months.
  • Participants with primary severe valvular disease (e.g., aortic stenosis).
  • Have a life expectancy of less than 12 months.
  • Participants with irreversible brain damage from preexisting cerebral disease.
  • Participants with a contrast dye allergy unable or unwilling to undergo pretreatment with steroids and/or diphenhydramine.
  • Participants participating in any other interventional cardiovascular clinical trial.
  • Participants who would be unable to comply with the study's follow-up visit schedule; or
  • Participants who had any prior unsuccessful attempt at implantation of biventricular pacing (BiVP), His Bundle Pacing (HBP), or Left Bundle Branch Pacing (LBBP) device.

This study investigates heart failure due to left ventricular systolic dysfunction. It focuses on comparing two types of pacing: His bundle branch pacing and Left bundle branch pacing.

The study evaluates the effectiveness and safety of these pacing methods. It looks at how they impact quality of life, physical activity, and hospitalizations related to heart failure.

  • Who can participate: Adults aged 18 and older with a left ventricular ejection fraction (LVEF) of 50% or less, and a QRS duration of 130 ms or more, or those with significant right ventricular pacing, may be eligible. Participants must be on optimized heart failure therapy.
  • Study details: Participants will be randomly assigned to receive either His or Left bundle branch pacing. The study will monitor their health outcomes, including heart failure hospitalizations and quality of life. A placebo is not involved in this study.
Updated on 02 Oct 2025. Study ID: 23-0629

Find a site

We have submitted the contact information you provided to the research team at {{SITE_NAME}}. A copy of the message has been sent to your email for your records.
Would you like to be notified about other trials? Sign up for Patient Notification Services.
Sign up

Send a message

Enter your contact details to connect with study team

Email

View email

Phone

Phone country flag

View phone
Investigator Avatar

Primary Contact

First name*
Last name*
Email*
Phone number*
Preferred way of contact
Please provide your preferred way of contact
Other language

Interested in the study

Select a study center that’s convenient for you, and get in touch with the study team.

Contact a study center